Pre-Descemet’s Endothelial Keratoplasty

Closure

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This segment demonstrates the final step of closure.

Keywords

  • main port
  • side port
  • astigmatism
  • anterior chamber maintainer
  • salt solution
  • speculum
  • intra ocular pressure

Conflict of Interest

The author declares no conflict of interest.

About this video

Author(s)
Soosan Jacob
First online
01 April 2020
DOI
https://doi.org/10.1007/978-3-030-43833-3_5
Online ISBN
978-3-030-43833-3
Publisher
Springer, Cham
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020

Video Transcript

This video demonstrates the final step that is closure. The main port and the side port are sutured closed. These sutures can be removed at one week postop in order to avoid any new astigmatism. I take a preplaced suture on the side port containing the anterior chamber maintainer. And before withdrawing the anterior chamber maintainer, I loosen the speculum and tie the knot and then withdraw in order to avoid an AC collapse.

The AC may, however, shallow a little bit. It does not matter. Continue to close the side port and then refill the anterior chamber carefully, making sure that your cannula is below the level of the graft. I like to inject some balanced salt solution into the anterior chamber at the end in order to have an 80% gas fill. Finally, the speculum is removed and then intraocular pressure is checked to make sure that it is not excessively high.